System and method for determining incontinence device replacement interval

ABSTRACT

A method of providing hygiene services to a patient. The method includes acquiring patient status data of a patient with a sensor. Incontinence event data is acquired with an incontinence detection system. After the occurrence of the incontinence event, a sleep status of the patient is determined based the patient status data. A time period to provide hygiene services to the patient is determined based on the incontinence event data and the sleep status of the patient.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority under 35 U.S.C. § 119(e) to U.S.Provisional Application Ser. No. 62/427,398, filed Nov. 29, 2016, whichis hereby incorporated by reference herein.

BACKGROUND

The present disclosure relates to incontinence detection systems andparticularly, to incontinence detection systems that use a pad beneath apatient lying in a hospital bed or garment secured to the patient. Moreparticularly, the present disclosure relates to a method of providinghygiene services to a patient by determining incontinence devicereplacement intervals.

Good medical practice dictates that patients who are incontinent shouldbe removed from the wet environment as soon as possible to avoid skinbreakdown which can potentially lead to pressure ulcers. Incontinencedetection systems alert caregivers to the occurrence of an incontinentevent so that hygiene services can be provided as quickly as possible.Hygiene services may include changing patient linens, changing patientgarments, and/or moving the patient to a clean hospital bed. However,many patients experience difficulty sleeping in a hospital bed. As aresult, it may not be advantageous to provide hygiene servicesimmediately after the occurrence of an incontinent event. Particularly,if a patient experiences an incontinent event while sleeping, thecaregiver may not want to wake the patient to provide hygiene services.

SUMMARY

The present application discloses one or more of the features recited inthe appended claims and/or the following features which, alone or in anycombination, may comprise patentable subject matter:

According to a first aspect of the present disclosure, a method ofproviding hygiene services to a patient is provided. The method includesacquiring patient status data of a patient with a sensor, and acquiringincontinence event data with an incontinence detection system. After theoccurrence of the incontinence event, the method includes determining asleep status of the patient based the patient status data. A time periodto provide hygiene services to the patient is determined based on theincontinence event data and the sleep status of the patient.

In one embodiment, the method includes at least one of detecting anincontinence event and measuring a fluid volume of the incontinenceevent. Incontinence event data may be acquired with an incontinencedetection system that includes a sensor pad including a plurality ofelectrically conductive traces. The presence of at least one of urine orfecal matter may be detected, wherein, after detecting fecal matter, thetime period to provide hygiene services is as soon as possible.Alternatively, after detecting urine, the method may include determiningwhether the patient is asleep or awake, wherein, if the patient isawake, the time period to provide hygiene services is as soon aspossible.

In one embodiment, the method includes measuring at least one vital signof the patient, for example measuring at least one of brain activity ofthe patient with an electroencephalogram and heart activity of thepatient with an electrocardiogram.

In one embodiment, the method includes measuring movement of thepatient. Movement of the patient may be measured with at least onepressure sensor. Movement of the patient may be measured with a loadcell.

In one embodiment, hygiene services include at least one of changing thepatient's linens, changing the patient's garments, and moving thepatient to a clean hospital bed.

In one embodiment, the method includes at least one of monitoring theoccurrence of at least one of non-rapid eye movement sleep and rapid eyemovement sleep, determining a period of time that the patient has slept,and comparing a fluid volume of the incontinence event to the period oftime that the patient has slept.

In one embodiment, if the patient is asleep and the fluid volume iswithin a range of approximately 0 ml to approximately 10 ml, hygieneservices are not provided. In one embodiment, if the patient is asleepand the fluid volume is within a range of approximately 10 ml toapproximately 20 ml, the time period to provide hygiene services iswithin a range of approximately 1 hour to approximately 2 hours. In oneembodiment, if the patient has been asleep for less than approximatelyfour hours and the fluid volume is within a range of approximately 20 mlto approximately 40 ml, the time period to provide hygiene services iswithin a range of approximately 1 hour to approximately 2 hours. In oneembodiment, if the patient has been asleep for a range of approximatelyfour hours to approximately six hours and the fluid volume is within arange of approximately 20 ml to approximately 40 ml, the time period toprovide hygiene services is within a range of approximately 30 minutesto approximately 1 hour. In one embodiment, if the patient has beenasleep for over approximately six hours and the fluid volume is within arange of approximately 20 ml to approximately 40 ml, the time period toprovide hygiene services is as soon as possible. In one embodiment, ifthe patient has been asleep for less than approximately four hours andthe fluid volume is within a range of approximately 60 ml toapproximately 80 ml, the time period to provide hygiene services isapproximately 30 minutes to approximately 1 hour. In one embodiment, ifthe patient has been asleep for over approximately four hours and thefluid volume is within a range of approximately 60 ml to approximately80 ml, the time period to provide hygiene services is as soon aspossible. In one embodiment, if the patient is asleep and the fluidvolume is greater than approximately 80 ml, the time period to providehygiene services is as soon as possible.

According to a second aspect of the present disclosure, a system forproviding hygiene services to a patient is provided. The system includesa sensor configured to acquire patient status data of a patient and anincontinence detection system configured to acquire incontinence eventdata. The system also includes, a processor configured to, after theoccurrence of the incontinence event, determine a sleep status of thepatient based the patient status data. The processor is furtherconfigured to determine a time period to provide hygiene services to thepatient based on the incontinence event data and the sleep status of thepatient.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other features of the various embodiments of themethods and apparatuses described herein will become more apparent fromthe following detailed description and the accompanying drawings inwhich:

FIG. 1 is a perspective view from the head end on the patient's left ofa patient support apparatus, wherein the patient support apparatusincludes a vital signs monitoring system in communication therewith;

FIG. 2 is a block diagram of a portion of the electrical system of thepatient support apparatus of FIG. 1 used to determine a tare weight ofthe patient support apparatus;

FIG. 3 is a diagrammatic representation of the positions of a number ofload cells relative to the patient support apparatus of FIG. 1;

FIG. 4 is a schematic diagram of the pneumatics of an airbox assemblyfor the mattress shown in FIG. 1;

FIG. 5 is a schematic view of an embodiment of a sensor pad fordetecting moisture presence and moisture volume;

FIG. 6 is a plan view of a wearable sensor pad for detecting moisturepresence above a minimum volume;

FIG. 7 is a perspective view of an embodiment of a sensor pad fordetecting moisture presence above a minimum volume showing two RFIDsensors each connected to a respective sensor trace grid;

FIG. 8 is a block diagram of a system that determines a hygiene servicesschedule for a patient;

FIG. 9A is a flowchart showing a method for determining a hygieneservices schedule for a patient;

FIG. 9B is a continuation of the flowchart of FIG. 9A showing a methodfor determining a hygiene services schedule for a patient; and

FIG. 10 is a chart showing a hygiene services schedule for a patient.

DETAILED DESCRIPTION

The present disclosure relates to systems and methods for detectingincontinence or other moisture caused events associated with a personbeing monitored. Thus, it should be appreciated that the systemsdescribed herein are able to detect biofluids such as blood, urine,fecal matter, interstitial fluid, saline, or any other fluid having alarge concentration of ions that easily conduct electricity. The term“incontinence” as used herein is intended to cover all of thesebiofluids. The present disclosure further describes systems and methodsfor reporting detected incontinence events to hospital caregivers, anurse call system, or an EMR (electronic medical record) system to allowpatients to be quickly removed from the soiled environment. The presentdisclosure further describes a method of determining a patient hygieneschedule. It should be appreciated that the patient hygiene scheduledetermines an approximate time to provide hygiene services to thepatient based on an approximate amount of incontinence and anapproximate amount of time that the patient has been sleeping.

A patient support apparatus 10 embodied as a hospital bed is shown inFIG. 1. It will be appreciated that, although the present embodimentsare described with respect to a hospital bed, the present embodimentsmay be utilized with any occupant support, for example, a hospital bed,a residential bed, a chair, a wheelchair, a mattress, a stretcher, apatient transport device, or any other type of person support apparatus.The patient support apparatus 10 has a fixed bed frame 20 which includesa stationary base frame 22 with casters 24 and an upper frame 26. Thestationary base frame 22 is further coupled to a weigh frame 30 (shownin FIG. 3) that is mounted via frame member 32 a and 32 b (both shown inFIG. 3) to an adjustably positionable mattress support frame or deck 34configured to support a mattress 18. The mattress 18 defines a patientsupport surface 36 which includes a head section 38, a seat section 40,and a foot section 42. The patient support apparatus 10 further includesa headboard 12 at a head end 46 of the patient support apparatus 10, afootboard 16 at a foot end 48 of the patient support apparatus 10, and apair of siderails 14 coupled to the upper frame 26 of the patientsupport apparatus 10. The siderail 14 supports a patient monitoringcontrol panel and/or a mattress position control panel 54 as shown inFIG. 1. The patient support apparatus 10 is generally configured toadjustably position the mattress support frame 34 relative to the baseframe 22. Although the embodiment shows the control panel 54 supportedon a siderail 14, the control panel 54 may be affixed to any portion ofthe patient support apparatus 10. In one embodiment, the control panel54 may be configured as a remote that is either wirelessly coupled to orwired to the patient support apparatus 10.

Conventional structures and devices may be provided to adjustablyposition the mattress support frame 34, and such conventional structuresand devices may include, for example, linkages, drives, and othermovement members and devices coupled between base frame 22 and the weighframe 30, and/or between weigh frame 30 and mattress support frame 34.The details of the structure of a suitable bed embodiment of a patientsupport apparatus may be found in application number PCT/US2016/034908filed May 27, 2016 and titled “PATIENT SUPPORT APPARATUS”, which isincorporated herein in its entirety. Control of the position of themattress support frame 34 and mattress 18 relative to the base frame 22or weigh frame 30 is provided, for example, by a patient control pendant56, a mattress position control panel 54, and/or a number of mattresspositioning pedals. The mattress support frame 34 may, for example, beadjustably positioned in a general incline from the head end 46 to thefoot end 48 or vice versa. Additionally, the mattress support frame 34may be adjustably positioned such that the head section 38 of thepatient support surface 36 is positioned between minimum and maximumincline angles, e.g., 0-65 degrees, relative to horizontal or bed flat,and the mattress support frame 34 may also be adjustably positioned suchthat the seat section 40 of the patient support surface 36 is positionedbetween minimum and maximum bend angles, e.g., 0-35 degrees, relative tohorizontal or bed flat. Those skilled in the art will recognize that themattress support frame 34 or portions thereof may be adjustablypositioned in other orientations, and such other orientations arecontemplated by this disclosure and disclosed in the aforementionedapplication number PCT/US2016/034908.

The patient support apparatus 10 may be in communication with one ormore vital signs monitoring sy stems 108. Although only one vital signsmonitoring system 108 is shown in FIG. 1, the patient support apparatus10 may include any number of vital signs monitoring systems 108. Thevital signs monitoring system 108, as shown, is in wirelesscommunication with the patient support apparatus 10. In otherembodiments, the vital signs monitoring system 108 may be in wiredcommunication with the patient support apparatus 10. The vital signsmonitoring system 108 may activate or control electronically-controlledcomponents associated with the patient support apparatus 10. As shown,the electronically-controlled components include an electrocardiogram112. In one embodiment, the electronically-controlled components mayalso include at least one of an electroencephalogram 114 and/or aventilator 116, among other things. In one embodiment, theelectronically-controlled components may not include theelectrocardiogram 112. It will be appreciated that anyelectronically-controlled components for monitoring vital signs may beincorporated into the vital signs monitoring system 108. In oneembodiment, the electronically-controlled components may include anycombination of electrocardiogram 112, electroencephalogram 114 and/or aventilator 116, among other things. As discussed in detail below, thevital signs monitoring system 108 is configured to monitor varioussignals from the electronically-controlled components to receive andanalyze vital sign data (e.g., to determine the brain activity, cardiac,respiratory, and/or snoring state of a patient, among other things).

In one embodiment shown diagrammatically in FIG. 2, the patient supportapparatus 10 includes a weigh scale system 60 and an alarm system 90, asdisclosed in the aforementioned application number PCT/US2016/034908.The weight scale system 60 is configured to determine a plurality set ofcalibration weights for each of a number of load cells 50 for use indetermining a location and an accurate weight of the patient. Todetermine a weight of a patient supported on the patient support surface36, the load cells 50 are positioned between the weigh frame 30 and thebase frame 22. Each load cell 50 is configured to produce a voltage orcurrent signal indicative of a weight supported by that load cell 50from the weigh frame 30 relative to the base frame 22. The weigh scalesystem 60 includes a processor 62 that is in communication with each ofthe respective load cells 50. The processor 62 includes amicroprocessor-based controller 52 having a flash memory unit 64 and alocal random-access memory (RAM) unit 66. The local RAM unit 66 isutilized by the controller 52 to temporarily store informationcorresponding to features and functions provided by the patient supportapparatus 10. A memory 80 may store predetermined calibration positions70, as described in FIG. 3. Additionally, a timer 53 may monitor thetiming of weight displacement as measured by the weigh scale system 60.The alarm system 90 is configured to trigger an alarm if the movement ofthe patient exceeds a predetermined threshold. The alarm may be anaudible alarm 92 and/or a visual alarm 94. The visual alarm 94 may bepositioned, for example, on the mattress position control panel 54and/or the patient control pendant 56.

In the embodiment of FIG. 3, four such load cells 50 a-50 d arepositioned between the weigh frame 30 and the base frame 22; one eachnear a different corner of the patient support apparatus 10. All fourload cells 50 a-50 d are shown in FIG. 3. Some of the structuralcomponents of the patient support apparatus 10 will be designatedhereinafter as “right”, “left”, “head” and “foot” from the referencepoint of an individual lying on the individual's back on the patientsupport surface 36 with the individual's head oriented toward the headend 46 of the patient support apparatus 10 and the individual's feetoriented toward the foot end 48 of the patient support apparatus 10. Forexample, the weigh frame 30 shown in FIG. 3 includes a head end framemember 30 c mounted at one end to one end of a right side weigh framemember 30 a and at an opposite end to one end of a left side framemember 30 b. Opposite ends of the right side weigh frame member 30 a andthe left side weigh frame member 30 b are mounted to a foot end framemember 30 d. A middle weigh frame member 30 e is mounted at oppositeends to the right and left side weigh frame members 30 a and 30 brespectively between the head end and foot end frame members 30 c and 30d. The frame member 32 a is shown mounted between the right side framemember 30 a and the mattress support frame 34, and the frame member 32 bis shown mounted between the left side frame member 30 b and themattress support frame 34. It will be understood that other structuralsupport is provided between the weigh frame 30 and the mattress supportframe 34.

A right head load cell (RHLC) 50 a is shown as positioned near the righthead end of the patient support apparatus 10 between a base supportframe 44 a secured to the base 44 near the head end 46 of the patientsupport apparatus 10 and the junction of the head end frame member 30 cand the right side frame member 30 a, as shown in the block diagram ofFIG. 3. A left head load cell (LHLC) 50 b is shown as positioned nearthe left head end of the patient support apparatus 10 between the basesupport frame 44 a and the junction of the head end frame member 30 cand the left side frame member 30 b, as shown in the block diagram ofFIG. 3. A right foot load cell (RFLC) 50 c is shown as positioned nearthe right foot end of the patient support apparatus 10 between a basesupport frame 44 b secured to the base 44 near the foot end 48 of thepatient support apparatus 10 and the junction of the foot end framemember 30 d and the right side frame member 30 a, as shown in the blockdiagram of FIG. 3. A left foot load cell (LFLC) 50 d is shown aspositioned near the left foot end of the patient support apparatus 10between the base support frame 44 b and the junction of the foot endframe member 30 d and the left side frame member 30 b. In the embodimentshown in FIG. 3, the four corners of the mattress support frame 34 areshown extending beyond the four corners of the weigh frame 30, and hencebeyond the positions of the four load cells 50 a-50 d.

A weight distribution of a load among the plurality of load cells 50a-50 d may not be the same depending on sensitivities of each of loadcells 50 a-50 d and a position of the load on the patient supportsurface 36. Accordingly, a calibration constant for each of the loadcells 50 a-50 d is established to adjust for differences in the loadcells 50 a-50 d in response to the load. Each of the load cells 50 a-50d produces a signal indicative of the load supported by that load cell50. The loads detected by each of the respective load cells 50 a-50 dare adjusted using a corresponding calibration constant for therespective load cell 50 a-50 d. The adjusted loads are then combined toestablish the actual weight supported on the patient support apparatus10.

To determine a set of calibration constants, a calibration weight issequentially placed on each of several predetermined calibrationpositions 70 on the patient support surface 36. For example, whendetermining a set of initial calibration constants, the calibrationpositions 70 a, 70 b, 70 c, and 70 d corresponding to the location ofthe load cells 50 a, 50 b, 50 c, and 50 d, respectively, are used. Thecalibration weight has an established mass which is used to determinethe calibration constants. The respective initial calibration constantsare determined by placing the calibration weight on a first calibrationposition 70 a and measuring the weight distribution of the predefinedcalibration weight on each of the respective load cells 50 a-50 d. Therespective loads detected by each of the load cells 50 a-50 d thatcorresponds to the current distribution of the predefined calibrationweight on the first calibration position 70 a is established and storedin the local RAM unit 66. The predefined calibration weight is thenmoved to the next calibration position 70 b and the measuring andstoring steps are repeated until a set of load weights are establishedfor each of the respective calibration positions 70 a-70 d.

The plurality sets of load weights that correspond to the location ofeach load cell 50 a-50 d are used to generate the calibration equations(1)-(4) set forth below.

CWRH=C ₁ L ₁ +C ₂ L ₂ +C ₃ L ₃ +C ₄ L ₄  (1)

CWLH=C ₁ L ₁ +C ₂ L ₂ +C ₃ L ₃ +C ₄ L ₄  (2)

CWRF=C ₁ L ₁ +C ₂ L ₂ +C ₃ L ₃ +C ₄ L ₄  (3)

CWLF=C ₁ L ₁ +C ₂ L ₂ +C ₃ L ₃ +C ₄ L ₄  (4)

where CWRH, CWRF, CWLF, and CWLH are the predefined calibration weightwhen the predefined calibration weight is positioned on the calibrationpositions 70 a-70 d which correspond to the RHLC 50 a, RFLC 50 b, LFLC50 c, and LHLC 50 d, respectively, C₁, C₂, C₃, and C₄ are calibrationconstants for RHLC 50 a, RFLC 50 b, LFLC 50 c, and LHLC 50 d,respectively, and L₁, L₂, L₃, and L₄ are the load weights on RHLC 50 a,RFLC 50 b, LFLC 50 c, and LHLC 50 d, respectively. CWRH, CWRF, CWLF, andCWLH are all equal to the predefined calibration weight. Thus, theinitial calibration constants C₁, C₂, C₃, and C₄ are established using astandard Gauss-Jordan or other appropriate elimination method andequations (1)-(4) are solved to obtain values for initial calibrationconstants C₁, C₂, C₃, and C₄. The initial calibration constants C₁, C₂,C₃, and C₄ are applied to the loads detected by the respective loadcells 50 a-50 d is used to determine the total weight supported on theload cells 50 a-50 d. It should be appreciated that the calibrationconstants may be dynamically refined based on the position and/or weightof the load.

In some embodiments, the position of the patient is determined bycalculating a locus of a centroid of the patient load. The centroid ofthe patient load is represented as a point relative to a referenceposition or a coordinate axis of the patient support apparatus 10. Thepoint is a coordinate (X, Y) within a two-dimensional Cartesiancoordinate system having two horizontally extending X and Y axes alongthe patient support surface 36. The determination of the centroid of thepatient load is described in expired U.S. Pat. No. 5,276,432, which isincorporated by reference herein in its entirety for its disclosure of apatient load location determination approach.

FIG. 4 is a diagrammatic representation of a pneumatic portion of anairbox for a mattress system 110 (shown in FIG. 8) that is positionedwithin the mattress 18. The details of the structure of a suitablepneumatic mattress may be found in application number PCT/US2016/34908filed May 29, 2016 and having the title “PATIENT SUPPORT APPARATUS”,which is incorporated herein in its entirety. In the embodiment of FIG.4, the airbox includes a manifold 200 in a fluid communication with ablower 202, the blower having a positive pressure outlet 204 and anegative pressure inlet 206. In addition, the airbox includes a filter208 through which air is drawn to the negative pressure inlet 206. Thepositive pressure outlet 204 feeds a conduit 210. The conduit 210 feedsa first valve 212 that controls flow to and from the head zone 214 ofthe body support 216 through the supply tube 218. A second valve 220controls the flow to and from the seat zone 222 through the supply tube224. Both of the valves 212 and 220 are movable between an opened and aclosed position to connect the respective zones 214 and 222 to theconduit 210 as necessary. The conduit 210 also feeds a tap 226 that isconnected to a conduit 228 through a check valve 230. When the pressurein the conduit 210 is of sufficient pressure to overcome the check valve230, the check valve 230 will open and allow flow to the conduit 228which feeds two valves 232, associated with the left turn zone 234, and236, associated with right turn zone 238. In addition, conduit 210 isconnected to a valve 240 which is associated with the microclimatemanagement structure 242. In some embodiments, the body support 216includes an additional lumbar zone 244. The zone 244 is fed by a tube246 from a valve 248 which is connected to the conduit 210. Anotherconduit 250 is connected to a second port on each of the turn valves232, 236 and is connected to the inlet 206 of the blower 202. As will bedescribed in further detail, each of the zones 214, 222, 234, 238, 244may be exhausted through the valve 240, with the turn zones 234, 238being subjected to a rapid evacuation through the use of the negativepressure inlet 206 of the blower 202 to draw air from the zones 234, 238through the respective valves 232, 236

The zones 214, 222 may be vented through the valve 240 and microclimatemanagement structure 242 if the blower 202 is idle such that thepressure in the conduit 210 is lower than the pressure in the zones 214and 222. Opening of the valve 240 permits air from the zones 214 and 222to flow through the conduit 210 through the valve 240 and inlet tube 252to escape through the microclimate management structure 242.

Venting of the turn zones 234, 238 utilizes the three-way valvestructure of valves 232, 236 to connect the respective feed tubes 254 or256 to the conduit 250 so that the inlet side of the blower 202 pullsair through the conduits 266, 256 into the conduit 250 and, thereby, theinlet 206 of the blower 202. In certain conditions, the valves 232 or236 may be positioned to allow air to be drawn from the respective zone234 or 238 into the inlet 206 of the blower 202 and fed to one of theother zones 214 or 222. However, if no flow is needed to either thezones 214 or 222, the flow from the turn zones 234 or 238 is simplyexhausted through the valve 240 to the microclimate management structure242. As described in the aforementioned application numberPCT/US2016/34908, under certain conditions, the pressure in the turnzones 234, 238 may exceed the pressure in another zone, such as theother turn zone 234 or 238, or the head zone 214 or seat zone 222. Thismay be a result of the weight of a patient and the leverage provided byZ-plate assemblies to urge their out of the bladder assemblies. Toprotect against damage to a body support, both the head zone 214 andseat zone 222 include a respective check valve positioned on a bottomsurface of a lower layer. The check valves open at a relief pressurethat is higher than the maximum operating pressure of the body support,but lower than the pressure which components of the body support wouldfail due to excessive pressure. While the turn zones operate atpressures higher than the typical operating pressures of the bodysupport, the presence of the check valves mitigate the potential for adamaging overpressure condition to occur if the turn zones are ventedthrough the microclimate management system 242 and the flow isconstricted sufficiently to cause an overpressure condition in the bodysupport.

An air control board 258 includes logic that is operable to takepressure readings from the manifold 200 or any one of the zones 214,222, 234, 238, or 244 to determine which of the valves 212, 220, 232,236, or 240 to open or adjust to achieve the flow necessary to meet theoperational requirements of the body support 216. As described above,the head zone 214 is connected to a sense tube 260 which connects to apressure sensor 262, the pressure sensor 262 providing a signal to thelogic of the air control board 258 indicative of the pressure in thehead zone 214. Similarly, the sense line 280 is connected to a pressuretransducer 264 which provides a signal to the logic indicative of thepressure in the seat zone 222. The sense tube 266 provides a signal to apressure transducer 282 indicative of the pressure in the right turnzone 238 and the sense tube 270 is connected to a pressure transducer272 for determining the pressure in the left turn zone 234. The conduit210 is coupled to a sense line 274 that is also connected to a pressuretransducer 276, the pressure transducer 276 providing the logic a signalindicative of the pressure in the conduit 210. A sense line 278 connectsthe zone 244 to a pressure transducer 268 on the air can control board258.

FIGS. 5-7 schematically show two embodiments of a sensor system 300, 350that detects a volume of incontinence or other moisture. The details ofan incontinence sensor system of a patient support apparatus may befound in PCT/US2016/62167 filed Nov. 16, 2016 and having the title“INCONTINENCE DETECTION SYSTEMS FOR HOSPITAL BEDS,” which isincorporated herein in its entirety. Sensor system 300 is shown in FIG.5, which shows a substrate, or incontinence pad 306, resting on themattress 18, in an area or zone in which it is desired to conductsurveillance for unwanted moisture or other moisture relatedabnormalities. In other embodiments, the pad 306 is integrated into themattress 18. In still other embodiments, the pad 306 is integratedwithin an undergarment or other article of clothing or the pad 306itself is a diaper or disposable undergarment. In other embodiments, thepad 306 is integrated into any patient support apparatus.

The system 300 for detecting a volume of moisture on the mattress 18includes a plurality of sensor traces 302. The plurality of sensortraces 302 in the embodiment of FIG. 5 includes sensing traces 0-8. Itis contemplated that there are more or fewer sensor traces in otherembodiments. The sensor traces are placed at predetermined distances 304from one another and portions or segments of the traces lie in parallel.It should be understood, however, that while the segments (e.g., 0, 1,2, 3, 4, 5, 6, 7 and 8) are shown in FIG. 5 as linear segments, anysuitable spatial arrangement of the sensing traces 302 that maintainsthe desired spacing 304 between the sensing traces 302 work sufficientlyaccording to this disclosure.

In one embodiment, sensor traces 0-7 are generally Z-shaped, each with afirst end segment coupled to an RFID tag 308, a second end segmentspaced from the first segment and generally parallel therewith, and amiddle segment interconnecting the end segments and oriented insubstantially perpendicular relation with the end segments. The firstsegments of traces 0-7 are of decreasing length from trace 0 (i.e., thelongest first segment) to trace 7 (i.e., the shortest first segment).The second segments of traces 0-7 are of increasing length from trace 0(i.e., the shortest second segment) to trace 7 (i.e., the longest secondsegment). The middle segments of each trace 0-7 is approximately thesame length as each of the other middle segments of each of the othertraces 0-7. Trace 8 is generally L-shaped in the embodiment of FIG. 5,having a first segment coupled to the RFID circuit in substantiallyparallel relation with the middle segments of traces 0-7 and a secondsegment that is substantially perpendicular to the first segment oftrace 8 and substantially parallel with the first and second endsegments of traces 0-7. The length of the first segment of trace 8 isapproximately equal to the lengths of the middle segments of traces 0-7.

In some embodiments, the distance 304 between each of the adjacenttraces 0-8 is the same for each segment of each trace 0-8. In otherembodiments, the distance 304 between each of the sensor traces 0-8 isdifferent. It is also contemplated by this disclosure that, in someembodiments, the distance 304 between middle segments of traces 0-7 andbetween the middle segment of trace 7 and the first segment of trace 8is different than the distance 304 between respective first end segmentsof traces 0-7, respective second end segments of traces 0-7, and thesecond segment of trace 8 and the second end segment of trace 7 of othertraces. The distance 304 between each sensor trace is defined by one ormore moisture management criteria, for example.

The moisture management criterion includes a moisture-related propertyof the substrate pad 306 in some instances. For example, a moisturemanagement criterion may be a moisture-related property of the moistureabsorbent material of the incontinence pad (such as, for example, awicking or absorption property).

In one embodiment, the distance 304 is in the range of about 4 inches,based on a desired moisture sensitivity in the range of about 50milliliters (e.g., 304 is the distance that 50 ml of liquid travels inthe specified type of material forming the substrate 306 or a layer ofan incontinence pad in which the substrate 306 is integrated). Thus, anotification is issued by a notification device as described elsewhereherein, when the sensor traces 6-7 are exposed to moisture indicating anamount of moisture in the range of about 50 milliliters (i.e., enoughmoisture to bridge two adjacent traces 302). In another embodiment, ifmoisture is exposed to sensing traces 6, 7, 8, a signal is generatedindicating an amount of moisture in the range of 100 milliliters (i.e.,enough moisture to bridge three adjacent traces 302). Likewise, ifsensing traces 5, 6, 7, 8 are exposed to moisture, a signal is generatedindicating an amount of moisture in the range of 150 milliliters (i.e.,enough moisture to bridge four adjacent traces). Thus, system 300 is ahigh resolution incontinence detection system in that it is able todetermine how much biofluid is being sensed by traces 302. The sensortraces 302 are connected to a passive RFID tag 308 in the embodiment ofFIG. 5. RFID tag 308 is excited by a controller 310 which transmits anelectromagnetic signal and receives the response from the RFID tag 308.

Referring now to FIG. 6, system 350 is incorporated into a wearablesubstrate such as a diaper or other wearable pad 352. In thisembodiment, connector traces 354A, 354B extend from passive RFID tag 356and extend longitudinally in substantially parallel relation along theouter edges of a moisture zone 358 of the diaper or wearable pad 352.Shielding material or a shield 360 coat or otherwise overlie each of theconnector traces 354A, 354B to prevent the connector traces from beingexposed to moisture. Alternatively or additionally, connector traces354A, 354B lie outside moisture zone 358 in some embodiments so as toinhibit any chance for exposure to moisture that is present within zone358. In some embodiments therefore, shields 360 are not needed forcovering traces 354A, 65-4B and are omitted.

First and second sets of sensor traces 362, 364 extend from respectiveconnector traces 354A, 354B in a direction substantially perpendicularto traces 354A, 354B. Traces 362, 364 extend across the moisture zone358 but terminate prior to reaching the opposite trace 354A, 354B. Thus,in one embodiment, traces 362 each extend from trace 354B and terminalends of traces 362 are spaced from trace 354A. Similarly, traces 364each extend from trace 354A and terminal ends of traces 364 are spacedfrom trace 354B. A distance 366 (shown in FIG. 6 between the terminalend of one of traces 362 and trace 354A) is provided between eachterminal end of traces 362, 364 and the trace 354A, 354B spacedtherefrom.

The first 362 and second traces 364 are arranged in an alternatingpattern along the length of the diaper 352. Thus, trace 354 and itsaccompany traces 364 form a first comb-like pattern and trace 362 andits accompanying traces 362 form a second comb-like pattern. Thecomb-like patterns are arranged to that traces 362 are interdigitatedwith traces 364. The spacing distance 366 is smaller than a spacing 368between adjacent traces 362, 364. Because of the shielding 360 coveringtraces 354A, 354B, moisture that would otherwise make an electricalconnection between terminal ends of traces 362, 364 and the traces 354A,354B spaced therefrom by distance 366, is unable to do so. Instead, anelectrical connection is made between only when sufficient moisture ispresent to expose a first and second sensor trace 362, 364 to moistureacross distance 368. For example, in some embodiments contemplatedherein, distance 368 between first and second sensor traces 362, 364requires that 150 milliliters (ml) of moisture be present withinmoisture zone 358 before an electrical connection is made betweenadjacent traces 362, 364. Thus, the distance 368 is selected in the oneembodiment so that a signal from RFID tag 356 is generated in responseto moisture contacting one first sensing trace 362 and one secondsensing trace 364 which occurs when about 150 milliliters (ml) ofmoisture is present in the moisture zone 358.

By shielding connecting traces 354A, 354B with moisture resistant layers(not shown) that comprise shields 360, oversensitivity may be avoidedsuch that a signal may only be generated when a prescribed fluid volumeis present in the moisture zone 358. This prevents, for example,incontinence signals being sent by RFID tag 356 in response toperspiration or other moisture that bridges across any of spaces 366.Alternatively, connecting traces 354A, 354B are positioned outside ofmoisture zone 358 as mentioned above to achieve a similar result. Thefirst sensing traces 362 and second sensing traces 364 are spaced apartby a predetermined distance 368 that is based on a desired moisturesensitivity which also takes into account the wicking and absorbencyproperties of the diaper or other wearable pad 352 within zone 358.According to the present disclosure, shielded connector traces, similarto traces 354A, 354B, and unshielded sensor traces, similar to traces362, 364, also may be used in non-wearable pad embodiments, such each ofthe other pad embodiments disclosed herein.

FIG. 7 discloses another embodiment of an RFID implemented moisturedetection sensor system 400 employing a pair of sensors 410, 412 on asubstrate such as a patient support or pad 414. The discussion below ofsensor 410 is equally applicable to sensor 412. That is sensor 410 andsensor 412 are substantially the same although, in one embodiment,sensor 412 is a mirror image of sensor 410. Sensor 410 includes firstand second trace grids 416, 418 that are spaced apart and form asomewhat serpentine pattern on the bed. Trace 418 is generally U-shapedand trace 416 is generally M-shaped or W-shaped depending upon thedirection at which trace 416 is viewed. The U-shaped pattern of trace418 is interdigitated with the M-shaped pattern of trace 416. Thus,traces 416, 418 form a comb-like pattern. Moisture detection takes placeat the sensor 410 by way of a tuning circuit 420 connected to an RFIDtag 422. When moisture bridges any of the spaces between trace 416 andtrace 418, tuning circuitry 420 outputs a signal to RFID tag 422 which,in turn, emits a wireless signal indicating that moisture is present.

FIG. 8 is a block diagram of a system 500 which includes multiplecomponents of the patient support apparatus 10 that cooperate todetermine a hygiene services schedule for a patient supported on thepatient support apparatus 10. In one embodiment, hygiene services forthe patient may include changing the patient's linens, changing thepatient's garments, and/or moving the patient to a clean hospital bed,among other things. A method, as shown in the flowchart of FIG. 9A-9B isexecuted by the system 500. The vital signs monitoring system 108receives and transmits data to a sleep status calculator 504. Forexample, the data may represent brain activity, cardiac, respiratory,and/or snoring state of a patient. This data is transmitted to the sleepstatus calculator 504, where the data is analyzed along with data fromthe weigh scale system 60 and the mattress system 110. The data from theweigh scale system 60 and/or the mattress system 110 may representmovement of the patient, time that the patient is still, and/or bed exitdata, among other things. The sleep status calculator 504 includes aprocessor 506 and a memory 508 to analyze and compare the data from thevital signs monitoring system 108, the weigh scale system 60, and themattress system 110. The processor 506 may include amicroprocessor-based controller having a flash memory unit and a localrandom-access memory (RAM) unit. The memory 508 may store data relatedto incontinence events, sleep history, and/or sleep patterns.Additionally, these data are compared to data from the sensor system300, 350 to determine a hygiene services schedule for a patient. Thisschedule is displayed on a graphical user interface (GUI) 510 or similardevice.

Referring to FIGS. 9A-9B, determining the hygiene services scheduleincludes the detection and measurement of incontinence of the patient.At step 550, the sensor system 300, 350 detects the occurrence of anincontinent event and then, at step 552, determines a type ofincontinence, i.e. urine or fecal matter. If the type of incontinencecontains fecal matter 553, at an alert is sent to the GUI 510 indicatingthat the patient should receive hygiene services as soon as possible555, regardless of whether the patient is awake or asleep. It should beappreciated, that the terminology as soon as possible, is known to meaneither immediately or upon the first available opportunity. If the typeof incontinence contains urine 557, at step 554, a volume of the urineis determined by the sensor system 300, 350. In one embodiment, thevolume of the urine may be categorized into various ranges (i.e. 0 ml-10ml, 10 ml-20 ml, 20 ml-40 ml, 60 ml-80 ml, or greater than 80 ml). Theseranges are referenced as 556 in FIG. 10, which shows a chart fordetermining the hygiene services schedule. It should be noted that oneof ordinary skill in the art would recognize that any number of rangesrepresenting any volumes of incontinence are contemplated by thisdisclosure. It should also be recognized that the shown ranges arecontemplated to be approximate.

Determining the hygiene services schedule also includes determining asleep status of the patient. Particularly, data from the vital signsmonitoring system 108, the weigh scale system 60, and the mattresssystem 110 may be processed and analyzed by the sleep status calculator504 to determine whether a patient is sleeping or awake. The data mayalso be utilized to determine an amount of time that the patient hasbeen sleeping. For example, vital signs such as brain activity, heartrate, and/or respiratory rate may be indicative of a patient's sleeppatterns. This data, in one embodiment, may be processed and analyzed todetermine the occurrence of non-rapid eye movement (NREM) or rapid eyemovement (REM) sleep. Additionally, patient movement data in the form ofweight and/or pressure measurements from the weigh scale system 60 ormattress system 110 may provide evidence of sleeping, movement, and/orrestlessness. Particularly, movement of the patient results in changesto the weight measured by the weigh scale system 60 and/or the pressuremeasured by the mattress system 110, thereby indicating patientmovement, which may be attributed to restlessness, or lack of patientmovement, which may be attributed to patient sleep. Moreover, the weighscale system 60 or mattress system 110 may detect that the patient hasleft the patient support apparatus 10, thereby indicating that thepatient is awake. This data may be utilized to determine whether thepatient if awake or asleep and, if asleep, how long the patient has beensleeping. The length of time that a patient has been sleeping factorsinto the hygiene services schedule because it may be undesirable to wakea patient for hygiene services in certain circumstances.

At step 558, one or more vital signs are detected by the vital signsmonitoring system 108. Concurrently, patient movement is detected by theweigh scale system 60, at step 560. Based on the data from the vitalsigns monitoring system 108 and the weigh scale system 60, the sleepstatus calculator 504 determines, at step 562, whether the patient isawake or asleep. If the patient is awake 563, hygiene services arescheduled to be provided as soon as possible at the occurrence of anyincontinence event, at step 564. If the patient is determined to beasleep 565, the sleep status calculator 504 determines a time periodthat the patient has been asleep, at step 566. In one embodiment, thetime period that the patient has been asleep may be categorized intovarious ranges (i.e. less than four hours, greater than four hours,between four hours and six hours, or greater than six hours). Theseranges are referenced as 568 in chart in FIG. 10. It should be notedthat one of ordinary skill in the art would recognize that any number ofranges representing any time period are contemplated by this disclosure.It should also be recognized that the shown time periods arecontemplated to be approximate.

The sleep status calculator 504 determines a hygiene services schedulefor the patient based on an approximate time that the patient has beensleeping and an approximate volume of biofluid from the incontinenceevent. The time that the patient has been sleeping may be compared tothe approximate volume of the incontinence event to determine thehygiene services schedule. The hygiene services schedule provides anestimated time that within which the hygiene services should beprovided. This schedule may be displayed on the GUI 510 and/or otherwiseconveyed to the health care provider. FIG. 10 shows a plurality ofexemplary hygiene services schedules based on exemplary sleep statusesand incontinence volumes. These schedules are referenced as 572 in FIG.10. It should be noted that these schedules are exemplary and thatalternatives schedules are contemplated by this disclosure.

In one embodiment, if the patient is asleep and the fluid volume ofincontinence is within a range of approximately 0 ml to approximately 10ml, hygiene services are not provided regardless of how long the patienthas been asleep, at 600 (as shown in FIG. 9A). In another embodiment, ifthe patient is asleep and the fluid volume of incontinence is within arange of approximately 10 ml to approximately 20 ml, the time period toprovide hygiene services is within a range of approximately 1 hour toapproximately 2 hours regardless of how long the patient has beenasleep, at 602 (as shown in FIG. 9A). In a further embodiment, if thepatient has been asleep for less than approximately four hours and thefluid volume of incontinence is within a range of approximately 20 ml toapproximately 40 ml, the time period to provide hygiene services iswithin a range of approximately 1 hour to approximately 2 hours, at 604(as shown in FIG. 9B). In yet another embodiment, if the patient hasbeen asleep for a range of approximately four hours to approximately sixhours and the fluid volume of incontinence is within a range ofapproximately 20 ml to approximately 40 ml, the time period to providehygiene services is within a range of approximately 30 minutes toapproximately 1 hour, at 606 (as shown in FIG. 9B). In still anotherembodiment, if the patient has been asleep for over approximately sixhours and the fluid volume of incontinence is within a range ofapproximately 20 ml to approximately 40 ml, the time period to providehygiene services is as soon as possible, at 608 (as shown in FIG. 9B).In still yet another embodiment, if the patient has been asleep for lessthan approximately four hours and the fluid volume of incontinence iswithin a range of approximately 60 ml to approximately 80 ml, the timeperiod to provide hygiene services is approximately 30 minutes toapproximately 1 hour, at 606 (as shown in FIG. 9B). In a furtherembodiment, if the patient has been asleep for over approximately fourhours and the fluid volume of incontinence is within a range ofapproximately 60 ml to approximately 80 ml, the time period to providehygiene services is as soon as possible, at 608 (as shown in FIG. 9B).In still further another embodiment, if the patient is asleep and thefluid volume of incontinence is greater than approximately 80 ml, thetime period to provide hygiene services is as soon as possible, at 610(as shown in FIG. 9A).

Some of the above embodiments may be described in terms of functionalblock components and various processing steps. Such functional blocksmay be realized by any number of hardware and/or software componentsconfigured to perform the specified functions. For example, embodimentsmay employ various integrated circuit components, e.g., memory elements,processing elements, logic elements, look-up tables, and the like, whichmay carry out a variety of functions under the control of one or moreprocessors, microprocessors or other control devices. Similarly, wherethe elements of the above embodiments are implemented using softwareprogramming or software elements the embodiments may be implemented withany programming or scripting language such as C, C++, Java, assembler,or the like, with the various algorithms being implemented with anycombination of data structures, objects, processes, routines or otherprogramming elements. Furthermore, the embodiments could employ anynumber of conventional techniques for electronics configuration, signalprocessing and/or control, data processing and the like. The word“mechanism” may be used broadly and is not limited to mechanical orphysical embodiments, but can include software routines in conjunctionwith processors, etc.

The particular implementations shown and described herein areillustrative examples and are not intended to otherwise limit the scopeof the claims in any way. For the sake of brevity, conventionalelectronics, control systems, software development and other functionalaspects of the systems (and components of the individual operatingcomponents of the systems) may not be described in detail. Furthermore,the connecting lines, or connectors shown in the various figurespresented are intended to represent exemplary functional relationshipsand/or physical or logical couplings between the various elements. Itshould be noted that many alternative or additional functionalrelationships, physical connections or logical connections may bepresent in a practical device. Moreover, no item or component disclosedherein is intended to be an essential element. Numerous modificationsand adaptations will be readily apparent to those skilled in this artwithout departing from the spirit and scope of the embodiments.

Embodiments may be implemented with computer-executable instructions.The computer-executable instructions may be organized into one or morecomputer-executable components or modules. Aspects of the disclosure maybe implemented with any number and organization of such components ormodules. For example, aspects of the disclosure are not limited to thespecific computer-executable instructions or the specific components ormodules illustrated in the figures and/or described herein. Otherembodiments may include different computer-executable instructions orcomponents having more or less functionality than illustrated anddescribed herein.

Although certain illustrative embodiments have been described in detailabove, variations and modifications exist within the scope and spirit ofthis disclosure as described and as defined in the following claims.

1. A method of providing hygiene services to a patient, the methodcomprising: acquiring patient status data of a patient with a sensor;acquiring incontinence event data with an incontinence detection system;after the occurrence of the incontinence event, determining a sleepstatus of the patient based the patient status data; and determining atime period to provide hygiene services to the patient based on theincontinence event data and the sleep status of the patient.
 2. Themethod of claim 1, wherein acquiring incontinence event data comprisesdetecting an incontinence event.
 3. The method of claim 1, whereinacquiring incontinence event data comprises measuring a fluid volume ofthe incontinence event.
 4. The method of claim 1, wherein acquiringpatient status data comprises measuring at least one vital sign of thepatient.
 5. The method of claim 4, wherein measuring at least one vitalsign comprises measuring brain activity of the patient with anelectroencephalogram.
 6. The method of claim 4, wherein measuring atleast one vital sign comprises measuring heart activity of the patientwith an electrocardiogram.
 7. The method of claim 1, wherein acquiringpatient status data comprises measuring movement of the patient.
 8. Themethod of claim 7, wherein measuring movement of the patient furthercomprises measuring movement of the patient with a load cell.
 9. Themethod of claim 1, wherein acquiring incontinence event data with anincontinence detection system further comprises acquiring incontinenceevent data with an incontinence detection system including a sensor padincluding a plurality of electrically conductive traces.
 10. The methodof claim 1, wherein determining a sleep status includes monitoring theoccurrence of at least one of non-rapid eye movement sleep and rapid eyemovement sleep.
 11. The method of claim 1, wherein determining a sleepstatus includes determining a period of time that the patient has slept.12. The method of claim 11, wherein determining a time period to providehygiene services further comprises comparing a fluid volume of theincontinence event to the period of time that the patient has slept. 13.The method of claim 1, wherein detecting the occurrence of anincontinence event further comprises detecting the presence of at leastone of urine or fecal matter, wherein, after detecting fecal matter, thetime period to provide hygiene services is as soon as possible.
 14. Themethod of claim 13, wherein, after detecting urine, the method includesdetermining whether the patient is asleep or awake, wherein, if thepatient is awake, the time period to provide hygiene services is as soonas possible.
 15. The method of claim 14, wherein, if the patient isasleep and the fluid volume is below a first predetermined volume,hygiene services are not provided.
 16. The method of claim 14, wherein,if the patient is asleep and the fluid volume is between a firstpredetermined volume and a second predetermined volume greater than thefirst predetermined volume, the time period to provide hygiene servicesis between a first predetermined elapsed time and a second elapsed time,the second elapsed time greater than the first elapsed time.
 17. Asystem for providing hygiene services to a patient, the systemcomprising: a sensor configured to acquire patient status data of apatient; an incontinence detection system configured to acquireincontinence event data; a processor configured to, after the occurrenceof an incontinence event, determine a sleep status of the patient basedthe patient status data, the processor further configured to determine atime period to provide hygiene services to the patient based on theincontinence event data and the sleep status of the patient.
 18. Thesystem of claim 17, wherein the incontinence detection system is furtherconfigured to detect the incontinence event.
 19. The system of claim 17,wherein an incontinence detection system is further configured tomeasure a fluid volume of the incontinence event.
 20. The system ofclaim 17, wherein the sensor is further configured to measure at leastone vital sign of the patient.
 21. The system of claim 20, wherein theat least one vital sign comprises brain activity of the patient measuredwith an electroencephalogram.
 22. The system of claim 20, wherein the atleast one vital sign comprises heart activity of the patient measuredwith an electrocardiogram.
 23. The system of claim 17, wherein acquiringpatient status data comprises measuring movement of the patient.
 24. Thesystem of claim 17, wherein the incontinence detection system comprisesa sensor pad including a plurality of electrically conductive traces.25. The system of claim 17, wherein the processor is further configuredto determine a period of time that the patient has slept.
 26. The systemof claim 25, wherein the processor is further configured to determine atime period to provide hygiene services by comparing a fluid volume ofthe incontinence event to the period of time that the patient has slept.27. The system of claim 17, wherein the incontinence detection system isfurther configured to detect the presence of at least one of urine orfecal matter, wherein, after detecting fecal matter, the time period toprovide hygiene services is as soon as possible.
 28. The system of claim27, wherein, after detecting urine, the processor is configured todetermine whether the patient is asleep or awake, wherein, if thepatient is awake, the time period to provide hygiene services is as soonas possible.
 29. The system of claim 28, wherein, if the patient isasleep and the fluid volume is below a first predetermined volume,hygiene services are not provided.
 30. The system of claim 28, wherein,if the patient is asleep and the fluid volume is between a firstpredetermined volume and a second predetermined volume greater than thefirst predetermined volume, the time period to provide hygiene servicesis between a first predetermined elapsed time and a second elapsed time,the second elapsed time greater than the first elapsed time.